States struggle with prescription drug abuse

WASHINGTON — Governors and lawmakers in a handful of states are taking steps to tackle a growing scourge — prescription drug abuse. All but two states and the District of Columbia have enacted some kind of prescription drug monitoring program, but many state officials argue that this is not enough.

“This growing problem is so frightening because while FDA-approved prescription opiates are easy to get, many are just as addicting and dangerous as street heroin and crack cocaine,” Vermont Gov. Peter Shumlin said in his state of the state address last month.

Shumlin has proposed giving law enforcement personnel access to the state’s prescription drug monitoring system, currently accessible only to doctors and pharmacists, who enter a record in the database any time a patient is prescribed a potentially addictive drug, classified as a schedule II, III or IV controlled substance.

Prescription and illegal drugs are classified by the federal Drug Enforcement Agency in categories known as “schedules,” which are noted in prescription drug monitoring databases currently working in states. Schedule I drugs, including heroin and LSD, have no accepted medical use and are strictly illegal. Schedule II drugs have a high potential for abuse and include opiates and narcotics such as OxyContin and Ritalin. Schedule III drugs have a moderate addiction potential and include Vicodin and Tylenol with codeine. Schedule IV drugs have a lower level of abuse potential and include Xanax and Valium.

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Tennessee Gov. Bill Haslam also is taking aim at his state’s prescription drug database, which only requires prescribers to record that they’ve written a prescription. In a Haslam-backed bill, all prescribers and drug dispensers would be required to check the database prior to prescribing a controlled substance, and Tennessee would be able to share data with other states to cut down on doctor-shopping.

Tennessee is the second-most medicated state in the country, trailing only West Virginia, according to a Forbes Magazine analysis, which tracked the number of retail prescriptions filled compared to the number of residents in the state. Doctors in Tennessee have been slow to mobilize around stopping prescription drug abuse, but the state’s largest physician organization says it hopes to support a bill in the legislature this year to address the problem.

Legislators in neighboring Kentucky, which ranked as the fourth-most medicated state, have filed bills to regulate pain management facilities and require all prescribers to register each prescription in the state’s prescription drug database.

“What we’re trying to do is strike at the heart of the problem,” said Kentucky House Speaker Greg Stumbo, in an interview with the Louisville Courier-Journal. “That’s the doctors who overprescribe and the patients who try to manipulate the system.”

Major medical and public health organizations, including the federal Centers for Disease Control and Prevention, are encouraging physicians to consider other pain management treatment options before prescribing high doses of controlled substances.